Kaiser Daily Global Health Policy Report

In The News

Forbes: Trump Expands Abortion ‘Gag Rule,’ Threatening A Record $8.8 Billion In Global Aid
“…Back in January, immediately following his inauguration (and the global Women’s March), President Donald Trump signed an executive order reviving the so-called Mexico City policy, versions of which Republican presidents have used since 1984 to block U.S. support for aid groups that offer abortion counseling or services abroad. [Monday,] the Office of the [U.S. State Department’s] Spokesperson announced the launch of a new plan, known as ‘Protecting Life in Global Health Assistance,’ which would extend the Mexico City policy or ‘gag rule’ to apply to a range of other crucial health services with U.S. support, including programs to stop the spread of HIV/AIDS and malaria…” (Burns, 5/16).

Foreign Policy: To ‘Protect Life,’ State Department Rolls Out Women’s Health Policy Critics Call a ‘Death Warrant’
“…The controversial ban won praise from pro-life groups who say it aligns U.S. foreign aid funding with conservative policies, but drew condemnation from many in the NGO community, who called it a ‘death warrant’ for some women in developing countries…” (Mellen/Gramer, 5/16).

The Guardian: Trump expands policy that bans U.S. aid for overseas abortion providers
“…The new terms of the ban will apply to $8.8bn in existing foreign aid provided by the State Department, USAID, and the Department of Defense — dwarfing the $600m in programming that fell under the ban during previous administrations…” (Redden, 5/15).

Slate: Donald Trump Holds $8.8 Billion In Global Health Aid Hostage, Calls It ‘Protecting Life’
“…Now, all overseas nonprofits must accept as a condition of any U.S. assistance that they cannot so much as tell a woman that abortion is a legal option. According to the State Department, the expanded gag rule will apply to funds earmarked for HIV/AIDS prevention, malaria treatment, maternal health programs, Zika response, and child health programs in addition to funds for reproductive health and family planning programs…” (Cauterucci, 5/15).

CIDRAP News: Report outlines priorities for U.S. global health role
“An expert committee convened by the National Academies of Sciences, Engineering, and Medicine [Monday] launched a report designed to advise the Trump administration on key global health priorities, suggesting new strategies to maintain U.S. leadership in the area. … The report highlights four main priority areas: (1) global health security; (2) HIV, tuberculosis, and malaria; (3) women and children; and (4) cardiovascular disease and cancer…” (Schnirring, 5/15).

Mosaic: How HIV became a matter of international security
“…AIDS became the first epidemic in modern history to morph beyond a topic of public health into an issue of national and even international security. Without collaboration between countries, between scientists and military personnel, between industry and government, the disease would have claimed more than the 35 million lives it has to date. … By the early 1980s, diseases that ravaged the human population seemed like they might become a thing of the past. Smallpox had been eradicated worldwide by 1980; vaccination campaigns during the 1960s and 70s meant that diseases like polio, mumps, and measles affected far fewer people. ‘People were talking about conquering infectious disease once and for all,’ says Joshua Michaud, the associate director of global health policy at the Kaiser Family Foundation. … But when AIDS was discovered in 1981, that illusion was shattered. ‘We had a lot of magic bullets, we had technical fixes to everything. Then HIV happened,’ Michaud says…” (Ossola, 5/16).

Fortune: More Than 1.2 Million Kids Die Each Year From Preventable Causes
“More than 1.2 million young people across the world aged 10 to 19 died in 2015, according to a new report by the World Health Organization (WHO). And the majority were killed by preventable causes like road traffic injuries, suicides, and interpersonal violence…” (Mukherjee, 5/16).

Humanosphere: ‘Small investments’ in adolescent health care could yield enormous results
“…The severity of the problem comes into sharp focus when looking more closely at the data. Low- and middle-income countries located in Africa and Southeast Asia represent more than two-thirds of the total adolescent deaths. They are most likely to die from HIV/AIDS, lower respiratory infections, meningitis, and diarrhea…” (Murphy, 5/16).

NPR: How Many Teenagers Die Each Day … And Why
“…[T]he WHO report points out that while many programs around the world are dedicated to improving infant mortality, very few programs address for the needs of vulnerable tweens and teens. We interviewed WHO epidemiologist Kate Strong — one of the study authors — to learn more about those needs, and what it will take to meet them…” (Singh, 5/16).

U.N. News Centre: Deaths of 1.2M adolescents mostly preventable with improved health services — U.N. agency
“…The report, Global accelerated action for the health of adolescents (AA-HA!): Guidance to support country implementation, shows that road injuries are the leading cause of adolescent deaths among 10-19 year-olds, killing some 115,000 adolescents each year — the majority older adolescent boys. … Among girls, the leading cause of death for younger adolescents is pneumonia and other lower respiratory infections resulting from indoor air pollution caused by cooking with dirty fuels, while older adolescent girls are more likely to die from pregnancy complications. Self-harm and suicide are the third leading cause of adolescent mortality, particularly among older adolescents, and predominantly among girls…” (5/16).

United Press International: WHO: 1 million adolescents a year die from preventable causes
“… ‘Adolescents have been entirely absent from national health plans for decades,’ Dr. Flavia Bustreo, assistant director general with the WHO, said in a press release. ‘Relatively small investments focused on adolescents now will not only result in healthy and empowered adults who thrive and contribute positively to their communities, but it will also result in healthier future generations, yielding enormous returns’…” (Wallace, 5/16).

Reuters: More than half of world’s deaths still have no recorded cause: WHO
“More than half of all deaths have no recorded cause, making effective health monitoring and policymaking far more difficult, the World Health Organization (WHO) said on Wednesday. However, improved collection of statistics meant that 27 million of the world’s 56 million estimated deaths in 2015 were registered with a cause compared with only about a third in 2005, the U.N. health agency’s latest global health report said…” (Kelland, 5/17).

Humanosphere: Dozens of health workers dispatched to stop Ebola outbreak in DR Congo
“Officials with the World Health Organization confirmed an Ebola outbreak in the Democratic Republic of the Congo over the weekend. So far, there are at least 19 suspected cases and three deaths since the first infection in late April. Health officials from Congo, the U.N., and humanitarian groups were immediately sent to the north to respond to the outbreak…” (Murphy, 5/15).

STAT: WHO prepares experimental Ebola vaccine for possible first use in Democratic Republic of Congo
“The World Health Organization and outside experts are making arrangements to send an experimental Ebola vaccine to the Democratic Republic of Congo, should officials there say they need it to quell an outbreak there. The DRC has not yet formally requested the vaccine, and it’s unclear if or when it will…” (Branswell, 5/16).

U.N. News Centre: U.N. health agency deploying technical experts to site of Ebola outbreak in DR Congo
“The United Nations health agency is deploying technical experts to the Democratic Republic of the Congo (DRC) amid an outbreak of Ebola virus near its northern border with the Central Africa Republic, the agency’s regional director for Africa confirmed. Matshidiso Moeti visited the capital Kinshasa on Saturday to discuss with national authorities and partners ways to mount a rapid, effective, and coherent response in order to stop the ongoing outbreak…” (5/15).

Global Health NOW: The Best Intervention: Gavi CEO Seth Berkley’s Q&A, Part I
“Vaccines — the exemplar of a cost-effective public health intervention — reach only a fraction of those who need them. Perhaps just 10 percent of the world’s children receive all 11 vaccines recommended by the WHO, says Seth Berkley, CEO of Gavi, the Vaccine Alliance. Reversing that imbalance is the public-private partnership’s mission. … In this two-part Q&A with Global Health NOW, Berkley shares his insights on Gavi’s latest priorities, the challenges of vaccine hesitancy, why an imperfect malaria vaccine deserves pilot trials in three countries, and other issues…” (Simpson, 5/12).

Global Health NOW: Big Ideas: Gavi CEO Seth Berkley’s Q&A, Part II
“…In this 2nd part of the GHN Q&A, Gavi’s CEO shares his concerns about the expansion of the vaccine hesitancy movement, explains why digital identity technologies in low- and middle-income countries can help improve vaccine coverage, and discusses the value of testing the flawed but potentially important malaria vaccine…” (Simpson, 5/16).

Devex: In southern Philippines, a test for WHO’s unconventional venture
“…[I]n the city of Tagum in Davao, located in the southern Philippine region of Mindanao, the WHO is playing a rather unconventional role: Working with local actors to improve maternal, newborn, and child health. It is one of the two areas across the Western Pacific region — the other one is in several municipalities in China — where the health aid agency has taken the decision to work with local authorities and development partners at the subnational level…” (Ravelo, 5/16).

New York Times: India Allows Abortion for 10-Year-Old Rape Victim
“An Indian court ruled on Tuesday that doctors were free to carry out an abortion on a 10-year-old girl who was raped and impregnated by her stepfather. Indian law severely restricts access to abortion after 20 weeks, except when the life or health of the mother is endangered. … But the law also allows for abortions under ‘exceptional circumstances,’ and the medical board petitioned the court for a decision on whether this situation met the criteria…” (Kumar, 5/16).

Editorials and Opinions

Washington Post: Joe Biden: Americans must stand with LGBT people around the world
Joe Biden, former vice president of the United States

“…[A]ny person of conscience, regardless of their religious or partisan beliefs, should be able to agree: Violence against any person, in any form, is intolerable. No one should be killed, tortured, assaulted, or harassed because of who they are. … Progress is possible. But we cannot wait, we cannot stand by. Governments, including ours, can wield the levers of diplomacy, defense, and foreign aid to promote and protect the human rights of all people. The foreign policy community can further incorporate and highlight LGBT equality in broader conversations about global health, gender-based violence, and human rights. Business leaders, especially those at the helm of multinational companies with a footprint in countries hostile to LGBT equality, can change the terms of the debate by highlighting the economic costs of discrimination. … Together, we will work to defend and advance the human rights of all people, and we will not rest until equality, at home and around the world, is fully realized. Until then, to all those suffering discrimination and violence simply because of who they are or whom they love, know this: The American people are on your side” (5/16).

Washington Post: The ‘global gag rule’ on abortion just got much bigger — and much worse
Editorial Board

“…The consequences [of the Mexico City policy] will be catastrophic. Developing countries have spent the past decade revamping their health systems so patients can get many types of care in one place. That means organizations will have to choose between abandoning clients in need of abortions and losing the funding they need to fight tuberculosis, malaria, and more. PEPFAR’s inclusion will deal a heavy blow to HIV prevention efforts, and may turn back one of the program’s greatest successes: a decrease in mother-to-child transmission. Worse still, judging from past experience, the policy may not even achieve its aim. … The few exceptions to the policy, such as for humanitarian assistance and relief, are a thin silver lining in the cloud the United States has cast over the globe. The same goes for the State Department’s promise that the amount of global health assistance the United States provides will not change — only who receives it. Those dollars simply will not go as far if, for example, State hands them out to U.S.-based global health organizations, which are not covered under the policy, instead of their indigenous partners, which could use the funds not only to address present crises but also to equip their communities to manage future ones. … For years, the United States has led the way in building a healthier world. It is up to lawmakers to stop the president from reversing that progress” (5/16).

“It’s impossible to accurately assess the impact of U.S. foreign aid without looking at how the money is spent. … Addressing corruption is important, but the broken contracts system can mean more than half of grants for overseas humanitarian work are spent in the U.S. President Trump’s ‘America First’ agenda will only make this worse. Forcing grantees to buy American rather than source locally results in inflated prices and doesn’t deliver what’s needed. Huge sums are also paid to big audit firms. These are some of the reasons why my organization, ActionAid USA, doesn’t accept USAID funding. Local people don’t want to be dependent on aid. They want to build their own businesses and feed their families. Overseas aid is very important, but it must be better delivered” (5/15).

Devex: Opinion: Eating for (global) health — whose responsibility is it?
Emmy Simmons, co-chair of AGree, senior adviser to the Center for Strategic and International Studies on food security, and member of the Global Panel on Agriculture, Food Systems and Nutrition

“…Without decisive actions to build food systems that promote good nutrition, and ensuring that the foods available provide affordable, appealing, and healthy eating choices, governments will pay a heavy price in terms of their populations’ mortality, physical health, mental well-being, economic losses, and degradation of the environment. To promote good nutrition, partnerships between governments, the private sector, and consumers are essential. … [P]romoting good nutrition — and healthy eating — is a shared responsibility. It is shared by consumers who are responsible for making nutritionally sound dietary choices from among the options provided within the food environment. Private sector actors who produce, process, and market foods as a matter of livelihood and business profit share the responsibility of ensuring food safety, quality, availability, and affordability. Governments must be concerned with ensuring the safety, health, and productivity of their populations. Healthy eating is an action that requires everyone to take action” (5/15).

From the Global Health Policy Community

Center for Global Development’s “U.S. Development Policy”: Good Faith or Hostile Takeover? How to Judge a Development Re-org Plan
Jeremy Konyndyk and Cindy Huang, both senior policy fellows at CGD, discuss the potential reorganization of the State Department and USAID, writing, “Any review of the U.S. foreign assistance structure should focus on how to enable that assistance to be deployed as effectively as possible. So, how to judge whether this process is truly focused on improving effectiveness, rather than just justifying cuts or rationalizing a predetermined re-org? We have our eyes on six key elements to watch: Does it address the changing global context? … Does it roll back aid fragmentation? … Does it engage the full State/USAID team? … Does it set clear targets and emphasize cost-effectiveness? … Does it have buy-in beyond the administration? … Does it seek reasonable efficiencies or debilitating cuts?” (5/16).

Oxfam America’s “Politics of Poverty”: Ebola: It’s not just a health problem
Aria Grabowski, policy adviser for accountable development finance at Oxfam America, discusses how the “recent Ebola outbreak in [the Democratic Republic of Congo (DRC)] serves as a reminder for the need to have integrated development, so every nation can prevent, detect, and respond to the threat of infectious diseases.” Grabowski writes, “To work toward this goal, Congress must reject President Trump’s proposed budget and fully fund International Affairs programs; and the administration must ensure that U.S. foreign assistance is focused on reducing poverty and creating strong institutions that can prevent and address challenges little by little rather than throwing billions of dollars at crises” (5/16).

Friends of the Global Fight Blog: Faith-based Coalition Members Sign Letter Championing Global Health
“Today, 53 members of the Faith-based Coalition for Healthy Mothers and Children Worldwide sent a letter to congressional appropriators championing robust funding for the international affairs account. This account, which comprises just one percent of the U.S. federal budget, provides critical funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria and U.S. bilateral partners. Friends of the Global Fight is partnering with Coalition members and Hope Through Healing Hands to advocate for funding for international affairs, global health, and the Global Fund…” (5/16).

Médecins Sans Frontières: Open letter from MSF to the Meeting of the G20 Health Ministers
In an open letter to the health ministers of the G20, Joanne Liu, president of MSF International, writes, “Every day in our medical operations, Médecins Sans Frontières (MSF) faces numerous barriers to providing medical care and dignity to people in need. We therefore welcome the decision of the G20 to place ‘Global Health’ on its agenda. … We believe the G20 states should pay particular attention to three priority areas. … Attacks on medical facilities … Emergency preparedness and response … Antimicrobial resistance and drug-resistant tuberculosis” (5/17).

Center for Strategic & International Studies’ “Take as Directed”: Pink Ribbon Red Ribbon and the Fight Against Cervical Cancer
Janet Fleischman, senior associate with the CSIS Global Health Policy Center, interviews Celina Schocken, CEO of Pink Ribbon Red Ribbon, “an independent affiliate of the George W. Bush Institute that focuses on cervical and breast cancer prevention and treatment. We asked her to speak about the organization’s work, including why cervical cancer screening should be part of HIV and reproductive health, new innovative technologies, and an April delegation led by President George W. Bush and Mrs. Laura Bush to Botswana and Namibia” (5/16).

WHO: Access to medicines: making market forces serve the poor
This chapter of the WHO’s “Ten years in public health 2007-2017” report focuses on access to basic medicine. “Since the landmark agreement on the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, WHO and its partners have launched a number of initiatives that are making market forces serve the poor. The WHO prequalification program is now firmly established as a mechanism for improving access to safe, effective, and quality-assured products…” (May 2017)

WHO: Towards ending tuberculosis: what gets measured gets done
This chapter focuses on the diagnosis, prevention, and treatment of tuberculosis, including drug-resistant strains. “WHO and its partners have pursued a culture of innovation, leading to a more effective and affordable diagnostic tool and the approval of two new anti-TB drugs. In May 2014, WHO launched an ambitious strategy to end TB by 2035, and is elevating the TB fight from the technical to the highest political levels…” (May 2017).

WHO: Women, newborns, children, and adolescents: life-saving momentum after a slow start
This chapter states, “After decades of stagnation, political will to cut the number of needless deaths of mothers and children emerged in 2010 with the United Nations’ US$ 40 billion Every Woman Every Child initiative. Dramatic progress came from better data collection, more births in health facilities, better nutrition, and vaccines against diarrhea and pneumonia, the biggest child killers. A revised global strategy views the focus on maternal, newborn, child, and adolescent health as an entry point for increasing universal health coverage…” (May 2017).

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 312 of the “Global Fund Observer.” The newsletter features articles on various topics, including an article on an audit of the Global Fund’s in-country supply chain processes; an article on the launch of an e-learning portal for Russian-speaking civil society organizations responding to HIV and TB epidemics; and an announcement that the Global Fund and Pink Ribbon Red Ribbon will collaborate on programming to prevent cervical cancer (5/17).

From the U.S. Government

CDC’s “Our Global Voices”: Transforming Hypertension Treatment in Barbados
Kenneth Connell, preclinical deputy dean and faculty lecturer in clinical pharmacology at the University of the West Indies at the Medical Sciences Cave Hill Campus in Barbados, discusses the Standardized Hypertension Treatment and Prevention Project (SHTP) to improve hypertension control in patients in Barbados, highlighting the project’s goals, activities, and progress. Connell writes, “While the pilot project is over, Barbados is just getting started. The SHTP project will continue as part of the Global Hearts Initiative, a larger initiative by the World Health Organization, U.S. CDC, and other partners to improve all aspects of cardiovascular health” (5/15).

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The Kaiser Daily Global Health Policy Report is a free daily publication that provides the latest news and information on global health policy, with a focus on U.S. global health policy and the developments that have important implications for the U.S. global health response.